Peripartum management of bipolar disorder: what do the latest guidelines recommend?

ABSTRACT

Introduction: Many women with bipolar disorder experience significant morbidity during pregnancy and the postpartum period. The use of evidence-based and up-to-date guidelines has the potential to improve maternal and neonatal care. We review the latest clinical practice guidelines to gather recommendations for the peripartum management of bipolar disorder.

Areas covered: Three electronic databases, MEDLINE/PubMed, the Cochrane Library, and the National Guidelines Clearinghouse were searched using various combinations of the following terms: bipolar disorder, pregnancy, postpartum, peripartum, puerperal, antenatal, postnatal, and guidelines. All guidelines retrieved were published, revised, or reaffirmed during the period from November 2010-June 2016.

Expert commentary: To date there are no exclusive guidelines for the peripartum management of bipolar disorder. Currently available guidelines do not provide sufficient guidance for clinicians to deliver optimal care to women before, during, and after pregnancy. The guidelines reflect the paucity of available literature on the peripartum management of bipolar disorder. Further research is urgently needed to strengthen the evidence supporting the guidelines recommendations.

KEYWORDS:

• Bipolar disorder
• management
• treatment
• prevention
• screening
• pregnancy
• postpartum
• lactation
• childbirth
• guidelines
• recommendation

Acknowledgments

The authors thank Elizabeth Pattison, MLIS, Librarian at Parkwood Institute, London, Ontario, Canada, for her assistance with the literature search and Ms. Christina Sommerdyk, M.Sc. for her assistance with the manuscript preparation.

Declaration of interest

V.Sharma has received grant support from, participated on scientific advisory boards for, or served on the speakers’ bureaus of AstraZeneca, Bristol-Myers Squibb, Cephalon, Elan Pharmaceuticals, Eli Lilly, Janssen, Lundbeck, Neurocrine Biosciences Inc., Pfizer, Servier and The Stanely Medical Research Institute. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.